Date of Regn. :
Appln. No.
M.O.P. VAISHNAV COLLEGE FOR WOMEN (AUTONOMOUS)
No.20, IV LANE, NUNGAMBAKKAM HIGH ROAD, CHENNAI - 600 034.
Website : www.mopvc.edu.in
APPLICATION FOR ADMISSION
M.A. (Broadcast Communication) 2015 - 2016 (Semester Pattern)
1.
Name of the Applicant : [BLOCK LETTERS] English :
(As in U.G Mark Sheet)
Tamil :
2.
Date of Birth :
5. Community :
3.
Religion :
6. Community Name :
4.
Nationality :
7. Mother Tongue :
8.
Name of the Parent / Guardian :
9.
Address for Communication :
OC
BC
MBC / DNC
SC / ST
10.Occupation of the Parent :
Designation :
Door No. / Street __________________
Area / District ____________________
Name of the Organisation / Company :
Office Address :
State _______________ PIN ________
Mobile Phone No.
Telephone No. :
E-mail Id :
Mobile Phone No. :
11. Annual Income of the Family :
12. Tick the
appropriate box
13.
Daughter of Ex-serviceman
Tamil Origin from
of Tamil Nadu origin
Andaman and Nicobar
Physically
Handicapped
(a)
Name of the Qualifying Exam
:
(b)
Name of the College and University
:
(c)
Year & Month of Passing
:
(d)
Marks Secured & class obtained
(Enclose Photocopies of Marksheets)
:
14.
Mention Additional Courses / Examinations Qualified if any :
15.
Work Experience if any :
16.
Mention achievements in Co-curricular / Extra curricular Activities :
17.
If old Student of the College, State Branch and Roll No. :
Sports /
NCC / NSS
M.O.P. Vaishnav College for Women ( Autonomous), Chennai - 34.
No. :
Website : www.mopvc.edu.in
2833 0262
Acknowledgement
Received Application Form for M.A. (Broadcast Communication) 2015 - 2016 course.
This is only an acknowledgement of registration of application and not an offer of seat.
Group Discussion &
Interview
Date : 4th June 2015
Time : 9.30 a.m.
18. Details of Qualifying Examination Passed :
Graduates from Engineering and Autonomous Colleges - enclose attested copies of Mark Sheets
English & Language not to be included in total.
Year
Subjects
Year & Month of
Passing
Marks Obtained
I
Total - A
II
Total - B
III
Total - C
Grand Total (A+B+C)
% Obtained
Attesting Officer’s (Gazetted Officer / Head of the Institution)
Name :
Designation :
Signature with Seal :
I declare that all the particulars furnished above are true and correct. I submit that I will abide by the rules and
regulations of the College.
Signature of the Parent / Guardian
Name & Signature of the Applicant
Station :
Date :
Note : Students who are yet to receive the final year results are asked to enclose Xerox copies of I and II Year
Mark Lists.